


Graveyard Shift

by JE_Talveran



Category: World of Warcraft
Genre: Alternate Universe - Canon Divergence, As if I can do anything else, Everyone's gay, F/F, More tags as necessary, Slow Burn, Sylvanas is a bad-ass nurse, They talk sooner than 15k in I promise, Useless Lesbians Finding Eachother, medical AU
Language: English
Status: In-Progress
Published: 2019-03-19
Updated: 2019-03-19
Packaged: 2019-11-24 03:57:34
Rating: Teen And Up Audiences
Warnings: Graphic Depictions Of Violence
Chapters: 1
Words: 3,142
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/18161180
Author URL: https://archiveofourown.org/users/JE_Talveran/pseuds/JE_Talveran
Summary: Sylvanas Windrunner is quite content as a third-shifter nurse at Quel'Duin Outpost. Sure, there's the constant pestering of her sisters, and so what if she's halfway through a plan to strangle Arthas - the most arrogant Emergency Fellow she knows. She's happy!She most certainly does not need the excitement that surrounds the transfer of new Resident Jaina Proudmoore from Dalaran General.She definitely does not need the troubling rumors that some of the corpses in the small holding freezer are starting to move again.





	Graveyard Shift

**Author's Note:**

> We cried and sobbed and wept and bled tears. But when we were finished, all we could do was continue living.  
> -Nnedi Okorafor, Who Fears Death

Sylvanas Windrunner glared at the clock and knew for a damned certainty that it had, somehow, gone backwards. There was no way in hell it had just turned six. After all, she swore it’d been six when she’d transported her most recent discharged patient: a somnolent dwarf out to the gryphon-aerie for transport to Dalaran General. He’d fallen into one of the open-air shafts the Wildhammer had exposed along the Hillsbrad Range and had struck his head hard against the bottom. A CT scan had revealed the beginnings of a subarachnoid bleed. Deemed stable, he’d been transferred to the regional hospital for neurosurgery to take off. 

So when Sylvanas left the chill of the early morning for the sluggishly warm unit and noticed the Charge Nurse already standing up to come meet her, she stubbornly set her ears straight and pretended like she didn’t see the oncoming encounter.

“Squad coming in,” is how Alleria Windrunner finally greeted her. Her honey-blonde hair was swept up into a messy knot at the back of her skull which only meant that the night was progressing from ‘shit’ to ‘even more shit’ at a breakneck pace. Her ears were angled back, agitation warring with exhaustion as she hung up the phone that, more often than not was tucked in the crook of her neck as she took in arrivals.

Sylvanas Windrunner decided that her sanity was worth a few more minutes of blissful quiet, and continued on her path back to her assignment. She swung ‘round the corner of the Charge Desk, pausing only to swipe at the container of cleaning towels as she continued on her way.

She didn’t respond to Alleria’s announcement. No need to, Sylvanas reasoned to herself, the story often changed in the space between the first call and arrival. The cot she pushed ahead of her squeaked in protest as she popped the control level to ‘steer’ to maneuver it into room eighteen.

She scowled as Alleria followed her, her sister ducking out of sight to pluck up fresh linens from the cabinet. The stink of bleach surrounded them as she joined Sylvanas in the efficient wipe-down between patients; A swipe over the various cords, a brush over the enchanted runecloth pad, and then a moment to clean the monitors.

“According to AEMS, they felt that they had to be intubated,” Alleria continued as casually as if she commented on the weather.

“Who did?” Sylvanas looked up from tucking the linen sheet. “AEMS?” She referred to the eastern Alterac Emergency Response Service. Undergeared, and underprepared, they were the only service that willingly went into the war-torn foothills of the Alterac outskirts.

“The patient, apparently.”

Sylvanas paused at that, and fixed Alleria with a droll look. “And you’re putting them here?” She asked. Usually, that sort of dramatics before the patient even hit the bay doors meant a long night with a very fussy, but very stable individual.

Alleria glanced out towards the shimmering board that hung behind the Charge Desk. As results came through, and orders were given, it adjusted in real-time to the flow of the department. “You’ve got the open room.”

Sylvanas sighed, “Is it possible to pretend that you didn’t see that?” She was thinking on the other three patients she still needed to round on, and the prospect of a new admission pushing her even further behind loomed on the horizon.

Alleria winced in sympathy but was already backing out of the room to go manage another last-minute decision before day shift arrived. They heard the whoosh of the doors at the same time, and when her sister’s face fell, Sylvanas darted out to see what fresh hell had arrived.

Coming through the double-doors, the AEMS two-man squad wheeled in a patient sitting upright. An older, human woman, she had a non-rebreather mask on - and Sylvanas’ ear twitched at the familiar hiss of oxygen.

The woman was slumped, with her head lolling to the left. Sylvanas’ ear twitched as dread crept into her gut.

“Elyse Peren, human aged forty-five. She had an asthma attack at home after cleaning up the aftermath of a dragon attack. Awake at the scene, threatened to pass out. Pulse is one-oh-five, respirations twenty, and breathing ninety-seven percent on ten liters of oxygen.” The closest of the EMS squad rattled out his report as they pulled the cot into the room and prepared to transition the patient onto the cart. Sylvanas and Alleria reached over the mattress to grab the near end of the sheet. “Ready?”

“One, two, three!” They pulled, and EMS pushed, and as Elyse was transferred, Sylvanas immediately pulled the facemask back to assess the human’s airway.

One second passed, then two, then three four five, and finally six before Sylvanas confirmed that the report of ‘respers twenty’ was complete bullshit.

She slapped one of the runes on the back wall and went immediately towards the ambu-bag, tearing it out from it’s protective cover as the shrill alarm of a code blue rang out.

“I’ve got airway,” Sylvanas called out as Alleria reached for the immediate-release that slammed the cart back until the patient was flat underneath them. Alleria nodded in acknowledgement as she started compressions. 

The first push against Elyse’s chest sent a bubble of crimson up past her lips. It dribbled down her chin, bright, red, and thick; but it wasn’t frothy, which meant it wasn’t from her lungs. 

“Shit, I think she bit her tongue.” Sylvanas secured the ambu-bag around Elyse’s mouth and nose. The first squeeze came with a high-pitched squeal and Sylvanas adjusted her grip to hold a better seal. This time, the squeeze didn’t come with a squeak of foul-smelling air. She counted to six, and bagged dutifully.

AEMS stepped out of the room as the unit swarmed over in response to the code. Sylvanas’ smile was grim, she knew, as she greeted their respiratory technician. “Jekyll, here. Please take over.”

“Do we have access?” Someone called out as the crash cart was wheeled outside the room.

A quick sweep over Elyse’s - no, the patient’s body. It was easier to compartmentalize when she disassociated the name. “No,” Sylvanas relinquished the airway to Jekyll’s command. She glanced to Alleria, as her sister pushed steadily away with the compressions. “Swap?”

“You’re better … at lines…” Alleria managed between compressions. Tendrils of her hair coiled down around her neck, and her stethoscope dangled precariously over her shoulders. Sylvanas removed it as she ducked past her side. She looked to the rush of newcomers to the room.

One face was new to her. Human, freckled like she spent time in the open air - a rare sight among the night shifters, with blonde hair was plaited neatly into a side-braid. She looked young, but her blue eyes gleamed with intelligence. Her white coat had the emblem of Dalaran University over the left breast. Medical Student. _Jaina Proudmoore_ was embroidered proudly underneath it.

“You,” she barked. “Proudmoore?”

Jaina blinked at her like a deer caught in a flare. “Y-yes?”

“You’ve got next compressions, all right?”

“Yes ma’am,” Jaina stammered through the reply, but stepped further into the room without hesitation regardless. Sylvanas inwardly smiled at the bravado. She’d been _terrified_ at her first code, and had trembled from ear-tips to toes the entire time.

Someone had wheeled the IV cart over, and before Sylvanas could open a drawer, one of the ‘trauma boats’ had been shoved at her. 

She glanced up to meet Modera’s twinkling gaze. “Figured I’d actually lend a hand once in a while,” the attending physician murmured as she gloved in. “What’s going on?”

“Asthma attack. Patient was apparently walky-talky at the scene, after transfer she wasn’t breathing. Couldn’t feel a pulse either.”

“Did the squad call ahead?” Modera inquired as Alleria swapped out with the human girl on compressions. She turned to the charge nurse as Alleria approached.

“They said the patient was alert and awake. Report on arrival was that the patient was stable on a non-rebreather.” 

Sylvanas allowed Alleria to take over the triage hand-off as she approached the patient’s right side. She dangled the woman’s arm over the edge of the stretcher and tied it off with a tourniquet. A glance up, and she noted the compression quality. “A little slower,” she instructed as she pulled the angiocath from it’s packaging. “You want to give the heart a chance to rebound.”

“Got it,” the girl panted, “Thanks.”

“Let Alleria know if you need to switch,” Sylvanas turned her focus to finding a vein. She ran her hands along the inner bend of the elbow. Behind her, she heard the opening snaps of another kit.

“All right, let’s get an IO as well,” Modera stepped into the room. “How’s she bagging, Jekyll?”

“Like shit,” he answered. “Her jaw’s locked, and there’s blood.”

“She bit her tongue,” Sylvanas repeated, pausing as she felt the delicate give-and-bounce of a vein underneath her index finger. She prodded against the resistance, then traced the sensation up.

The whir of the IO drill whined in the air.

“AED’s on,” Alleria called out. 

“Ok, stop for a rhythm check.”

Jaina stepped back. She was breathing hard, sweat dripped from her brow already.

Sylvanas guided the needle underneath the skin. It slid forward, then with a soft ‘pop’, she saw the flash of red. She advanced it, not bothering to wait for confirmation of the underlying rhythm.

“IO’s in.” That was Lamb, their medic. 

“Twenty in the right AC,” Sylvanas transitioned smoothly into collecting blood.

“Excellent. Rhythm check?”

Sylvanas looked over to the monitor as Alleria pressed her fingers against the patient’s femoral artery. Sylvanas reached for her radial. The monitor took a second to adjust from the frantic jittering of CPR before it went to a regular, bradycardic beat. One blip every five seconds, almost in time with Jekyll’s bagging.

“PEA.” Sylvanas judged.

“Agreed, resume CPR and let’s do Nepeta. What’s our time at?”

“Eight minutes.”

“After the Nepeta, we’re going with Deeprock.”

The patient laid on the stretcher, chest dipping inward with every compression. Lamb had taken over compressions, freeing Alleria to administer the reagents. As compressions resumed, the lazy blip of the monitor turned into a shattered dance that went in time with every downward thrust.

“Do we have a blood pressure?”

“Nothing yet.”

“Nepeta given.”

“Heard.”

“Deeprock next, please.” Modera rounded toward the head of the stretcher. “Let’s get ready to intubate.”

“What do you want to give?” Alleria poked through the airway cart.

“We’ll go with Harpy’s Bane,” Modera assessed the patient, then sighed. “No sedation, she’s out already.”

“Harpy’s Bane,” Alleria confirmed. “How much?”

Modera sucked on her front teeth. She was guessing the human’s weight. Sylvanas turned to give her own eye to it. Humans were hard to gauge in comparison to elven standards. Humans weren’t as, well, dense, as the typical elf. “We’ll go with hundred even.”

“Will you be able to get her jaw open?” Sylvanas wondered, straightening up. She felt her back twinge in protest. 

“She needs an airway,” Modera answered as she chose her preference for the endotracheal tube that would become the woman’s temporary airway. “If we can’t get it, I’ll have to cric her.” She referred to the messy procedure to cut through the patient’s neck to access the trachea directly. It was a last resort, and one that looked like it would be coming up fast.

Sylvanas wished she’d bothered for five seconds to grab one of the protective gowns - she hated wrapping up a shift in the OR scrubs. They were itchy, starchy, and never fit right over her hips.

Alleria seemed to have caught onto her thought train because she just chuckled softly. “That’s why I always pick reagents.”

“You can give me your top then.”

“Bite me.”

“Do we have a sat?”

Sylvanas broke off from her banter to check the monitor. Gnomish tech wasn’t the assurance of a priestly assessment, but it was better than nothing. “Nothing.”

“Shit. Ok, Jekyll. Hyperventilate for ten seconds. Sylvanas, hand me the scope?”

Sylvanas did so. Modera held the bladed instrument delicately in her right hand, just with the tips of her fingers as Jekyll finished bagging. Modera looked up as Alleria handed off the prepared reagent to the latest provider to walk in.

Liadrin was the newest transfer to the rural outpost, but Sylvanas had worked with her back in Quel’Thalas and trusted her judgement. She touched Sylvanas’ arm in greeting as she came to stand by the patient’s elbow. “How long have we gone?”

“Thirteen minutes now,” Jan, the dwarf who’d picked up the recorder role replied. “We’re in the widow for another Nepeta.”

“Push HB, then pulse check and Nepeta in two.”

Liadrin nodded. “Ready on your count.”

Modera angled her hand around the patient’s jaw. “Go.”

“HB given,” Liadrin pushed the paralytic and then squeezed the IV bag as a manual flush. Modera gave the elixir a minute before she started to pry the patient’s jaw open. “Shhiiiiit.”

Jekyll swept a suction cath to clear out the oral airway. Sylvanas watched the dark blood sweep through the tube into the collection container. It was followed by frothing white secretions, but still no pink. 

“Anything?” Liadrin asked, moving past Sylvanas now to stand near Modera at the head of the stretcher. “See the cords?”

“I … Light, I’m afraid I’m going to break her jaw.”

“Here.” Liadrin reached forward to press her bare fingertips against the patient’s jaw. A sheen of exhaustion washed over the elven woman as Sylvanas felt the rush of warmth and witnessed the gleam of divine energy bloom at the point of contact. The woman’s jaw slackened, and Modera nearly dropped the blade as the resistance gave away.

“Liadrin --”

“It’s all right,” Liadrin waved off the other woman’s concern. She stubbornly avoided Alleria’s gaze as well. “It didn’t take that much at all.”

“Pulse check is up,” Jan interjected.

“One second - I’m at the cords. Tube.”

Jekyll set it in Modera’s free hand. Sylvanas always marveled at how smoothly the attending made each intubation look as the tube slid past the patient’s open lips and down into her windpipe. “Ok,” Modera glanced up. “Pulse?”

Lamb backed off the compressions as Modera angled her insertion, then nodded to Jekyll. He pulled out the rigid wire that kept the tube stiff. 

Sylvanas glanced to the monitor. Her fingers went back to the radial. She felt the erratic rhythm from the final compressions. Then - “Still PEA.”

“All right. Nepeta 1mg.” Modera nodded to Jekyll. “You can balloon.” She stepped back as the airway was secured with the push of 10mg of air into the inflatable ring that would lock the tube in place in the patient’s trachea. “Resume compressions.”

Sylvanas leaned over the chest and listened as Jekyll resumed bagging, this time with the airway actually able to get oxygen down into the patient’s lungs. “I’ve got bilateral breath sounds.

“What are her sats?”

“Hands are cold, we’re not getting a waveform.”

“CO2 exchange?” Modera looked to Jekyll who was intent on the small filter at the end of the ET tube. “We’re twenty-seven at the lip.”

“Heard.” Jan scribbled the number down. “We’re at twenty-five minutes.”

Modera wiped at her brow with the back of her hand. She looked composed, but Sylvanas knew exactly what she was thinking. _They’re running out of time._

Modera paced the right side of the room as one by one, everyone took their turns at compressions. The medical student stepped up again, and Sylvanas swore she felt the rush of arcane energy as the girl went through her two minutes. Alleria had handed Sylvanas the next prepared doses of Nepeta and Deeprock as she took over compressions. Even Liadrin took a round, her jaw tight as she fought through her lightborne exhaustion. 

Every one of them went to the back of the line to rest and recover for the next bout of CPR. Every pulse check restarted the cycle.

Modera’s frustration was a silent, but tangible frisson in the air. “How long have we been going?”

“Forty minutes.”

Modera stopped. She stared hard at the patient currently underneath Alleria’s hands. Sylvanas knew what she was weighing. The length of downtime, the lack of a pulse, the way the woman’s ribs felt like jelly with every push. The steel-haired woman ground her teeth. “One more round, then I’m open for ideas.”

Sylvanas stepped back from her turn at compressions. Her shoulders burned, her neck was tight, and sweat stuck her scrubs against her skin. She went to the back of the line when she noticed that it was one person short. The medical student was missing.

Sylvanas poked her head out of the room. She had thought the girl made of stern stuff, but … 

“I can only promise that they’re doing everything that they can,” someone spoke softly. Sylvanas followed the voice to discover the medical student knelt down before a sobbing human woman.

Jaina’s hair was a sweaty mess stuck to her neck and temple, and she’d forsaken the white coat to reveal her own pair of sweat-stuck scrubs clinging to her shoulders. She had one hand covering the other human’s own.

Sylvanas hesitated, and ultimately decided to not interrupt. Instead, she looked down the way towards the back entrance and nearly sagged with relief as the first of the day shifters trickled through to duck into the staff lounge until morning huddle. 

From the room, she heard a shout.

“I’ve got CO2!”

Sylvanas caught the medical student’s eye as she turned at the announcement. She favored the girl with a tired smile as she went back in to care for her patient.

“Pulse check?”

Sylvanas set her fingers against the seam of one thigh, Alleria set hers against the other. Everyone held their breath as the monitor blipped steadily at seventy-three.

_Thump. Thump. Thump._

It was faint, and Sylvanas at first thought she’d screwed up - but then Alleria whooped. “I’ve got femorals!”

Liadrin leaned over the patient - no, Elyse. She could be Elyse again - and swept a penlight over the pupils. “I’ve got pinpoints, but PERRLA.” Sylvanas let out a breath. The pressure and the pulse were steady. The oxygen was creeping up to the high nineties. 

Modera clapped her on the shoulder, then looked to the rest. “All right. Order a chest X-ray. Let’s get her a OG as well - hell, what am I saying, this is what you’re paid for, you know the rest.”

The room laughed. They exchanged grins and knowing nods until Modera commanded their attention again.

“Good job, team. You rocked this.”

Alleria gave a thumbs up. “You know the saying, Mods --”

“ --I hate when you call me that --”

Alleria ignored her, her smile flashing fangs as her voice lilted into a sing-song; “Keep them alive --”

 _“Until Seven Oh Five!”_ The rest chorused.

**Author's Note:**

> I originally had an idea for a medical/nurse AU way back in October, but never got around to much more than a few ideas scribbled down on paper. However, after some encouragement, I decided that I'd take my job and somehow turn it romantic. 
> 
> Because we're still in Azeroth and not real-world, I've done my best to replace medications with Azerothian substitutes. Everything else, though, is as accurate to the hectic life of an Emergency Department as I live it. :)


End file.
